Hypertensive crisis is a potentially life-threatening complication of nearly all forms of hypertension. Vascular damage causing end-organ failure and direct complications such as intracerebral hemorrhage determine the outcome of hypertensive crisis. In the case of apparent end-organ damage immediate and effective lowering of blood pressure is necessary. In addition to drugs used traditionally in hypertensive crisis, a number of alternative antihypertensives such as urapidil or enalaprilat have been recently introduced for treatment of hypertensive crisis.